The Side-Effects of the COVID-19 Pandemic: Increased BMI z-Score in Children with Overweight and Obesity in a Personalised Lifestyle Intervention One Year after the Start of the Pandemic in The Netherlands

Abstract

Background: Early research showed weight gain in children during the COVID-19 pandemic. Objective: To compare changes in BMI z-score of children with overweight and obesity in a personalised lifestyle intervention before and during the pandemic. Methods: Changes in BMI z-score half a year (T6) and twelve months (T12) after the first lockdown were included for 71 children in the ‘2020 during COVID’ group and compared to 48 children in the ‘2019 before COVID’ group, using a marginal model for repeated measures (model 1). Model 2 corrected for lifestyle intervention characteristics, and model 3 corrected additionally for family characteristics. Results: The mean difference in BMI z-score change was significantly different at T12 (+0.07 in 2020 versus −0.09 in 2019, p = 0.022). Model 3 showed significant differences in BMI z-score change at both T6 (+0.15, p = 0.024) and T12 (+0.18, p = 0.016). This model also defined ‘having a mother with obesity’ (+0.13, p = 0.019) and the frequency of no-show consultations (+0.41 per missed consultation per month, p = 0.025) as related factors. Conclusions: Lifestyle intervention in children with overweight and obesity is less successful in decreasing BMI z-score during the COVID-pandemic. Identified risk factors for less success could contribute to identifying children with higher risks for, and possibly prevent, BMI z-score increase.

Who benefits most from outpatient lifestyle intervention? An IMI‐SOPHIA study on pediatric individuals living with overweight and obesity

“…Whereas having a mother with obesity has been linked with reduced weight loss or with increasing BMIz in childhood in smaller studies [40,41], we observed parental overweight/obesity as a proxy that hampers pronounced BMIz loss.…”

“…Patient and family adherence to behavioral recommendations is highly important for long-term outcome [45]. Moreover, the occurrence of COVID-19 was shown to negatively impact LI success [40].…”

“…Patient and family adherence to behavioral recommendations is highly important for long‐term outcome [45]. Moreover, the occurrence of COVID‐19 was shown to negatively impact LI success [40]. Conflicting priorities (family interests, leisure time with friends) and less time for physical activities, as well as financial aspects (e.g., fresh food being more expensive), might hamper success, especially after the end of LI.…”

Effect of the COVID-19 pandemic on obesity and its risk factors: a systematic review

“…Quality was assessed using the modified Newcastle–Ottawa Scale [ 19 ]. Out of included forty studies, 16 were classified as good quality [ 26 , 27 , 33 – 38 , 45 , 46 , 48 , 49 , 54 , 58 , 59 ] while twenty-four were also classified as satisfied [ 21 – 25 , 28 – 31 , 39 – 44 , 47 , 50 – 53 , 55 – 57 , 60 ]. Twenty-four articles were done on the adult population [ 22 , 23 , 25 , 26 , 28 – 30 , 36 , 38 , 42 – 44 , 46 , 48 – 50 , 55 , 57 – 59 ], five articles were done only adolescents [ 31 , 39 , 41 , 47 , 60 ], three research articles were also done on children [ 34 , 53 , 54 ], and finally, eight articles were done on both children and adolescents [ 21 , 24 , 27 , 33 , 37 , 45 , 52 , 56 ] as shown in Table 1 .…”

“…A history of COVID-19 infection leads to increased body weight [ 27 ]. Finally, missing consultations were reported as a risk factor for obesity during the COVID-19 pandemic [ 45 ]. As reported in Table 1 .…”